Individual
JARVIS WAYNE WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
14155 N 83RD AVE STE 105, PEORIA, AZ 85381-5640
(623) 486-7700
(623) 486-7703
Mailing address
14155 N 83RD AVE STE 105, PEORIA, AZ 85381-5640
(623) 486-7700
(316) 945-9131
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
008056
AZ
208600000X
Surgery Physician
05-42508
KS
208600000X
Surgery Physician
DO034734
DC
Other
Enumeration date
03/25/2013
Last updated
12/06/2023
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